Healthcare Provider Details

I. General information

NPI: 1790612091
Provider Name (Legal Business Name): TEIKO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S ARAPEEN DR STE 301
SALT LAKE CITY UT
84108-1205
US

IV. Provider business mailing address

675 S ARAPEEN DR STE 301
SALT LAKE CITY UT
84108-1205
US

V. Phone/Fax

Practice location:
  • Phone: 385-355-9108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMJI SRINIVASAN
Title or Position: CEO
Credential:
Phone: 650-714-1635